Hashibe M, Jacob B J, Thomas G, Ramadas K, Mathew B, Sankaranarayanan R, Zhang Z F
International Agency for Research on Cancer, Unit of Environmental Cancer Epidemiology, 150, cours Albert Thomas, 69372 Cedex 08 Lyon, France.
Oral Oncol. 2003 Oct;39(7):664-71. doi: 10.1016/s1368-8375(03)00074-5.
Several studies have suggested that low socioeconomic status (SES) is associated with a higher risk of oral cancer, but the association with oral premalignant lesions has not yet been explored. The aim of this study was to examine the association of education, occupation, income and SES index with oral premalignant lesions. A case-control study was conducted with data from the baseline screening of a randomized oral cancer screening trial in Kerala, India. There were a total of 927 oral leukoplakia, 170 oral submucous fibrosis, 100 erythroplakia and 115 multiple oral premalignant lesion cases and 47,773 controls. Subjects with high SES index had protective ORs for oral premalignant lesions, ranging from 0.6 to 0.7, after adjustment for age, sex, BMI, tobacco chewing, smoking, drinking and fruit/vegetable intake. Higher education levels were also associated with decreased risk of all four oral premalignant lesions. Protective ORs for income were observed for oral leukoplakia and possibly oral submucous fibrosis and erythroplakia. SES may be associated with oral premalignant lesions because of access to medical care, health related behaviors, living environment or psychosocial factors. Though the mechanism for the association is not clear, higher SES index, education and income were associated with decreased risk of oral premalignant lesions in our study.
多项研究表明，社会经济地位低下与口腔癌风险较高有关，但与口腔癌前病变的关联尚未得到探讨。本研究的目的是调查教育程度、职业、收入和社会经济地位指数与口腔癌前病变之间的关联。利用印度喀拉拉邦一项随机口腔癌筛查试验基线筛查的数据进行了一项病例对照研究。共有927例口腔白斑、170例口腔黏膜下纤维化、100例红斑和115例多发性口腔癌前病变病例以及47773名对照。在对年龄、性别、体重指数、嚼烟、吸烟、饮酒和水果/蔬菜摄入量进行调整后，社会经济地位指数较高的受试者对口腔癌前病变具有保护性优势比，范围为0.6至0.7。较高的教育水平也与所有四种口腔癌前病变风险降低有关。在口腔白斑以及可能在口腔黏膜下纤维化和红斑方面观察到收入的保护性优势比。社会经济地位可能因获得医疗保健、健康相关行为、生活环境或社会心理因素而与口腔癌前病变有关。尽管这种关联的机制尚不清楚，但在我们的研究中，较高的社会经济地位指数、教育程度和收入与口腔癌前病变风险降低有关。
